Healthcare Consulting Actuary – Provider & Value-Based Care, FSA

This is a fully remote position, open to applicants in Alaska, +10 more states.

📋 Description

• Model provider performance within MSSP, ACO REACH, and LEAD frameworks, encompassing benchmark projections, attribution, risk score dynamics, savings and loss estimations, as well as scenario testing across various risk tracks.

• Assess value-based contracts from the provider's perspective, which includes shared savings and downside risk, global and primary care capitation, episode and bundled payments, as well as downstream risk/reward distribution.

• Construct reimbursement models and facilitate rate negotiations with payers.

• Analyze claims, enrollment, and CMS data to address inquiries regarding utilization, cost drivers, risk adjustment, and network performance.

• Manage projects by scoping, budgeting, delegating technical tasks, overseeing timelines, and directly communicating with clients.

• Compose client-facing emails, memos, presentations, and reports intended for CFOs and medical group leadership.

• Collaborate with a senior consultant to assist in writing proposals.

• Provide support for other clients and projects within the practice as required.

• Advance towards managing client relationships and spearheading business development as part of career growth opportunities.

⛳️ Requirements

• A bachelor's degree in actuarial science, mathematics, statistics, economics, or a closely related quantitative field.

• FSA designation is required.

• Five to eight years of experience in healthcare actuarial work.

• Strong understanding of provider perspectives.

• Practical knowledge of at least one CMS or CMMI total cost of care program, such as MSSP, ACO REACH, Primary Care First, or any bundled payment model.

• Experience in developing benchmarks for CMS/CMMI programs and/or other risk-based arrangements.

• Familiarity with attribution methodologies.

• Knowledge of provider reimbursement mechanisms, including fee schedules, capitation, case rates, and episode payments.

• Proficiency in Excel.

• Experience in managing projects, which includes scoping, budgeting, delegation, timelines, and client interactions.

• Capability to convey technical work to non-technical audiences.

• Strong understanding of the US healthcare system.

• Experience working with detailed healthcare claims data.

• Proficiency in SQL, Python, R, or SAS.

• Self-motivated, independent, and capable of anticipating analytical and client needs.

• Excellent writing and speaking abilities.

• Ability to work autonomously as well as collaboratively within teams.

• Capacity to thrive in a fast-paced, client-focused environment.

• Entrepreneurial mindset.

• Preferred: Experience with CMS claim and claim line feed (CCLF) data.

• Preferred: Experience modeling participation decisions across CMS and CMMI programs.

• Preferred: Experience in supporting payer contract negotiations.

• Preferred: Experience in drafting proposals or client reports.

• Must be legally authorized to work in the United States without immigration support or sponsorship from Milliman now or in the future.

• A resume and cover letter are required.

🏝️ Benefits

• Comprehensive Medical, Dental, and Vision coverage for employees, their dependents, and domestic partners.

• Access to the Employee Assistance Program (EAP).

• Participation in a 401(k) Plan with company matching and profit-sharing contributions.

• Eligibility for a Discretionary Bonus Program.

• Flexible Spending Accounts (FSA) available for dependent care, transportation, and qualifying medical expenses.

• Paid Time Off (PTO), with full-time employees accruing 15 days annually.

• A minimum of 10 paid holidays each year.

• Assistance with adoption and fertility matters.

• Up to 11 weeks of paid parental leave for eligible employees.

• Life Insurance & AD&D coverage, with 100% of premiums paid by Milliman.

• Short-Term and Long-Term Disability coverage, fully funded by Milliman.

• Comprehensive on-the-job training in consulting skills and advanced actuarial techniques.

• Opportunities for skills training, career development, and mentoring.

• Involvement in Employee Resource Groups (ERGs).

• A managerial program designed to guide career growth.

• Access to Milliman’s healthcare data assets and modeling tools.